Name NEW COMPANY ORDER Orderer's Name * Firm Name * Email Address * Phone Number * COMPANY DETAILS Preferred Company Name * Is this name a Registered Business Name owned by the shareholder/s? If Yes, State/s or Territory/s registered: _ Is this a Special Purpose Company? (If Yes, please select type): Special Purpose Superannuation Trustee Home Unit Charitable Purposes Only Preferred State or Territory of Company Registration: State Picker QLD NSW ACT VIC TAS SA WA NT Registered Office Address * Suburb/Town * State or Territory * Postcode * Does the company occupy the Registered Office? If no, name of Occupier: _ Full Principal Place of Business * Suburb/Town * State or Territory * Postcode * Name of Ultimate Holding Company (if applicable): _ Holding Company ACN/ARBN Or Country of Incorporation (if not Australia) COMPANY OFFICEHOLDER/S AND SHAREHOLDER/S DETAILS Director ID Requirement It is now a requirement that all prospective directors obtain a Director ID prior to becoming a company director. Click here to find out more. Do all directors named below have Director IDs? Director_ID Yes No PERSON 1 Surname * Given Name(s) * Date of Birth * Place of Birth (Town/State/Country) * Home Address * Suburb/Town * State or Territory * Postcode * Positions Held: Director 1 Director Secretary 1 Secretary Public Officer 1 Public Officer Number of Shares: _ Class ORD Class ORD Or Class: _ Paid One Dollar 1 Paid $1/Share Or Paid to:$ If shares are held jointly or on behalf of a trustee, SMSF or other party, please provide full details below (such as name & address, etc.) _ _ Would you like to add another Company Officer/Shareholder? Person_2_YN YesNo
